HomeMy WebLinkAboutTEMPLO CALVARIO - 2008INSURANCE ON FILE A-2008-150
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UNTIL INSURANCE EXPIRES
~~~ C~ AGREEMENT BETWEEN
CLERK OF COUNCIL THE CITY OF SANTA ANA
DATE: ~-3-C~
AND
O ~ Cr~A~a-`) TEMPLO CALVARIO COMMUNITY DEVELOPMENT CORPORATION
Sea. G~r,zale-z FOR USE OF EMPOWERMENT ZONE FUNDS
This Agreement, made and entered into this 1st day of July, 2008, by and between
the City of Santa Ana a charter city and municipal corporation duly organized and existing
under the Constitution and laws of the State of California ("CITY"), and Templo Calvario
Community Development Corporation ("CONTRACTOR").
WITNESSETH
Recitals:
1. The City of Santa Ana, through the Santa Ana Empowerment
Corporation ("SAEC"), is the recipient of Federal Empowerment Zone
("FEZ") funds from the United States Department of Housing and Urban
Development ("HUD").
2. CITY desires to engage CONTRACTOR to provide the services at
the cost set forth in Exhibit A and for the services set forth Exhibit B,
hereinafter referred to as "said program" and CONTRACTOR represents
that it is qualified and willing to operate said program.
WHEREFORE, for and in consideration of the respective and mutual
covenants hereinafter contained and made, and subject to all the terms and
conditions hereof, the parties hereby agree as follows:
I. CONTRACTOR'S OBLIGATIONS
A. CONTRACTOR agrees to use all federal funds provided by CITY to
CONTRACTOR pursuant to this Agreement to operate said program, as set
forth in "Exhibit B," attached hereto and by this reference incorporated
herein. CONTRACTOR'S failure to perform as required may, in addition to
other remedies set forth in this Agreement, result in readjustment of the
amount of funds CITY is otherwise obligated to pay to CONTRACTOR
under Paragraph II hereof.
B. CONTRACTOR agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing
operation of its program. CONTRACTOR shall ensure that its staff shall also
obtain and maintain all required licenses, registrations, accreditation and
inspections from all agencies governing CONTRACTOR operations
hereunder.
Page 1 of 14
C. CONTRACTOR agrees that any facility/property used in furtherance
of said program shall be specifically zoned and permitted for such use(s)
and activity(ies). Should CONTRACTOR fail to have the required land
entitlement and/or permits, thus violating any local, state or federal rules and
regulations relating thereto, CONTRACTOR shall immediately make good-
faith efforts to gain compliance with local, state or federal rules and
regulations following written notification of said violation(s) from the CITY or
other authorized citing agency. CONTRACTOR shall notify CITY
immediately of any pending violations. Failure to notify CITY of pending
violations, or to remedy such known violation(s) shall result in termination of
grant funding hereunder. CONTRACTOR must make all corrections
required to bring the facility/property into compliance with the law within sixty
(60) days of notification of the violation(s); failure to gain compliance within
such time shall result in termination of grant funding hereunder.
D. All funds received by CONTRACTOR from CITY pursuant to this
Agreement shall be separately accounted for apart from any other funds of
CONTRACTOR, or of any principal or member of CONTRACTOR.
CONTRACTOR agrees that if CONTRACTOR receives $500,000 or more in
any Federal funds, CONTRACTOR shall have an annual audit conducted by
a certified public accountant in accordance with the standards as set forth
and published by the United States Office of Management and Budget
Circular A-133. CONTRACTOR shall provide CITY with a copy of said audit
30 days after receipt of the auditor's.. report(s), or nine months after the end
of the audit period following the program year in which this Agreement is
executed.
E. CONTRACTOR shall keep records of all funds received from CITY
under the terms and conditions of this Agreement in accordance with the
procedures set forth in the Agreement Accounting and Administrative
Handbook", a copy of which shall be provided to CONTRACTOR by CITY.
CONTRACTOR agrees to keep monthly records of all ethnic and racial
statistics of persons and families benefited by CONTRACTOR in the
performance of its obligations under this Agreement, including, but not
limited to, the number of low and moderate income persons and households
assisted in accordance with federal income limits, number of female heads
of households, and number of senior citizens assisted.
CONTRACTOR agrees to provide CITY with written cumulative (year-to-
date) reports of its activities on or before the 15th day of July, October,
January and April for the period beginning October 1, 2008 and through and
including the previous three-month reporting period setting forth the
activities, program accomplishments, new program information and year-to-
date program statistics on expenditures, caseload and activities. When
appropriate, pictures should be included. This Agreement shall terminate on
June 30, 2009, unless extended by mutual consent of the parties. Any
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extension shall be in writing, and executed by the Deputy City Manager for
Development Services and the City Attorney on behalf of CITY.
CITY, SAEC and the United States Government andlor their representatives
shall have access for purposes of monitoring, auditing, and examining
CONTRACTOR's activities and performance, to books, documents and
papers, and the right to examine records of CONTRACTOR's
subcontractors, bookkeepers and accountants, employees and participants
in regard to said program. CITY, SAEC and the United States Government
andlor their representatives shall also schedule on-site monitoring at their
discretion. Monitoring activities. may also include, but are not limited to,
questioning employees and participants in said program and entering any
premises or any site in which any of the services or activities funded
hereunder are conducted or in which any of the records of CONTRACTOR
are kept. Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law.
In the event CONTRACTOR does not make the above-referenced
documents available within the CITY of Santa Ana, California,
CONTRACTOR-.agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the. location where said records
and books of account are maintained.
F. All accounting records and evidence pertaining to all costs of
CONTRACTOR and all documents related to this Agreement shall be kept
available at the location where CONTRACTOR conducted the program, as
well as in the Orange County, California, for the duration of the Agreement
and thereafter for five (5) years after completion of an audit. Records which
.relate to (a) complaints, claims, administrative.. proceedings or litigation
arising out of the performance of this Agreement, or (b) costs and expenses
of this Agreement to which CITY or any other governmental. agency takes
exception, shall be retained beyond the five (5) years until resolution or
disposition of such appeals, litigation, claims, or exceptions.
G. CONTRACTOR agrees to comply fully with all federal, state and local
laws and court orders applicable to its operation whether or not referred to in
this Agreement. CONTRACTOR agrees that it has read, understood and
shall adhere to the legal obligations referred in Exhibit C.
H. CONTRACTOR shall be in good standing, without suspension by the
California Secretary of State, Franchise Tax Board and Internal Revenue
Service. Any change in the corporate status or suspension of
CONTRACTOR shall be reported immediately to CITY.
I. Subreceipient acknowledges and warrants that it shall at all times comply
with the laws, regulations and policies governing the use of FEZ funds,
including but not limited to, the limitations on use of FEZ funds set forth in
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P.L. 106-74 (2000), 24 CFR section 598.215 and Federal Register, April
16, 1998.
J. Without prejudice to any other provisions of this Agreement,
CONTRACTOR shall, where applicable, maintain the confidential nature of
information provided to it concerning participants in accordance with the
requirements of federal and state law. However, CONTRACTOR shall
submit to CITY, SAEC and or HUD or its representatives, all records
requested, including audit, examinations, monitoring and verifications of
reports submitted by CONTRACTOR, costs incurred and services rendered
hereunder
K. CONTRACTOR agrees that the performance of obligations
hereunder are rendered in its capacity as an independent contractor and
that it is in no way an agency of CITY.
L. CONTRACTOR agrees that 'rf CONTRACTOR violates any of the
terms and conditions of this Agreement or any prior Agreement whereby
FEZ funds were received by CONTRACTOR, or if CONTRACTOR reports
inaccurately, or if on audit there is a disallowance of certain expenditures,
CONTRACTOR agrees to remedy .the acts. or omissions causing the
disallowance or repay CITY all amounts spent in violation thereof.
M. CONTRACTOR agrees to maintain a record for each item of non-
expendable personal property acquired under the: terms of this Agreement.
Said record shall be made available to CITY upon request. The term "non-
expendable personal property" shall include leased and purchased
equipment.
N. CONTRACTOR hereby certifies and agrees that it will not use funds
provided through this Agreement to pay for entertainment, meals or gifts.
O. CONTRACTOR certifies that no appropriated funds may be
expended by the recipient of a federal contract, grant, loan or cooperative
agreement to pay any person for influencing or attempting to influence an
officer or employee of any agency, Member of Congress, or an officer or
employee of a Member of Congress in connection with awarding of any
federal contract, the making of any federal grant or loan, entering into any
cooperative agreement and the extension, renewal, amendment or
modification of any federal contract, grant, loan or cooperative agreement.
CONTRACTOR shall sign a certification to that effect in a form as set forth in
"Exhibit D," attached hereto and by this reference incorporated herein.
CONTRACTOR shall submit said signed certification to CITY prior to
performing any of its obligations under this Agreement and prior to any
obligation arising on the part of CITY to pay any sums to CONTRACTOR
under the terms and conditions of this Agreement.
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If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit a "Disclosure Form to Report Lobbying," in
accordance with its instructions.
P. CONTRACTOR agrees that except for the use of FEZ funds to pay
salaries and other related administrative or personnel costs, no persons who
exercise or have exercised any function with respect to FEZ activities
assisted under the terms of this Agreement, or who are in a position to
participate in adecision-making process or gain inside information with
regard to such activities, may,obtain a financial interest or benefit from a
FEZ-assisted activity of CONTRACTOR, either for themselves or those with
whom they have family or business ties, during their tenure or for one year
thereafter. This prohibition applies to any person who is an employee,
agent, consultant, officer, or elected or appointed official of CITY, or of any
designated public agencies; or the CONTRACTOR.
Q. CONTRACTOR acknowledges and warrants that prior to having -any
contractor perform work paid for by FEZ funds, that it shall be responsible
(i) for providing such .contractor with a copy of this Agreement, and (ii)
ensuring that any such contractor executes and. provides to the Executive
Director of the Community Development Agency a letter in substantially
the form of Exhibit E hereto; agreeing to be bound by the terms of this
Agreement.
R. CONTRACTOR acknowledges and warrants that during the term of this
Agreement it shall to the maximum extent feasible collaborate with other
CONTRACTORS to ensure that duplication of services is avoided. Such
collaboration shall include, but not be limited to, regular attendance (i.e.,
an attendance record exceeding 50%) and active participation in the
appropriate committee or committees established pursuant to the
Strategic Plan.
S. CONTRACTOR agrees to provide adrug-free work place and to execute a
certification as set forth in "Exhibit F" attached hereto and incorporated
herein by this reference.
T. CONTRACTOR shall comply with the general provisions, assurances, and
certifications attached hereto as "Exhibit G" and incorporated herein.
II. CITY'S OBLIGATIONS
Upon execution of this Agreement by CONTRACTOR, CITY shall pay to
CONTRACTOR from FEZ funds, when, if and to the extent received from HUD, for
Page 5 of 14
CITY's 2008-09 FEZ program year amounts expended by CONTRACTOR in
carrying out said program for fiscal year 2008-09 pursuant to this Agreement up to
a maximum aggregate payment of Eighty One Thousand Dollars ($81,000) for
CONTRACTOR'S performance in accordance with the payment schedule attached
hereto as "Exhibit A". Payments shall be made to CONTRACTOR through the
submission of periodic invoices, in a form prescribed by CITY, detailing such
expenses. CONTRACTOR agrees to submit the above-stated document to the
FEZ Navigator Office, 1000 E. Santa Ana Blvd., Suite 200, Santa Ana, CA 92701.
CITY shall pay such invoices within thirty (30) days after receipt thereof provided
CITY is satisfied that such expenses have been incurred within the scope of this
Agreement and that CONTRACTOR is in compliance with the terms and conditions
of this Agreement.
CITY has the right to de-obligate the funds hereunder and take such funding
back from CONTRACTOR due to any of the following reasons: (a) lack of
performance by CONTRACTOR; (b) lack of fiscal accountability of
CONTRACTOR; or (c) decrease in available funding.
III. PROGRAM INCOME
A. For the purposes of this Article (III) "Program income;' shall mean
gross income received by the CONTRACTOR directly generated from the
use of FEZ funds, except as provided below in Paragraph IILC. When such
income is generated by an activity that is only partially assisted with FEZ
funds, the income shall be prorated to reflect the percentage of FEZ funds
used.
B. Program income includes, but is not limited to each of the following:
1. Proceeds from the disposition by sale or long term lease of real
property purchased or improved with FEZ funds;
2. Proceeds from the disposition of equipment purchased with FEZ
funds.
3. Gross income from the use or rental of real or personal property
acquired by the CONTRACTOR with FEZ funds, less the costs
incidental to the generation of such income;
4. Gross income from the use or rental of real property owned by the
CONTRACTOR that was constructed or improved with FEZ funds,
less the costs incidental to the generation of such income;
5. Payments of principal and interest on loans made using FEZ funds;
6. Proceeds from the sale of loans made with FEZ funds;
7. Proceeds from the sale of obligations secured by loans made with
FEZ funds;
8. Interest earned on funds held in a revolving fund account;
9. Funds collected through special assessments made against
properties owned and occupied by households not of low and
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moderate income, where such assessments are used to recover all
or part of the FEZ portion of a public improvement.
C. Program income does not include income on grant advances from
the U.S. Treasury. The following items of income earned on grant advances
must be remitted to HUD for transmittal to the U.S. Treasury:
1. Interest earned from the investment of the initial proceeds of a grant
advance by the U.S. Treasury;
2. Interest earned on loans or other forms of assistance provided with
FEZ funds that are used for activities determined by HUD either to be
ineligible or to fail to meet a national objective or other federal criteria.
3. Interest earned on the investment of amounts reimbursed to the FEZ
program account prior to the use of the reimbursed funds for eligible
purposes.
D. The receipt of program income (as defined in Paragraph III.A.
hereinabove) by CONTRACTOR in the operation of said program shall be
recorded by CONTRACTOR and reported to CITY.
E. Program income received by CONTRACTOR shall be returned to
CITY unless otherwise providedfor in this Agreement.
IV. NONDISCRIMINATION
CONTRACTOR agrees that no person on the ground of race, color, national origin,
religion or sex will be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part
with FEZ funds.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If CONTRACTOR is a religious entity, CONTRACTOR hereby agrees that in
connection with the provision of the services CONTRACTOR shall provide with
FEZ funds:
A. CONTRACTOR shall not discriminate against any employee or
applicant for employment on the basis of religion and shall not limit
employment or give preference in employment to persons on the basis of
religion.
B. CONTRACTOR shall not discriminate against any person applying
for the services CONTRACTOR agrees to provide under the terms of this
Agreement on the basis of religion and shall not limit such services or give
preference to applicants for such services on the basis of religion.
Paqe 7 of 14
C. CONTRACTOR shall NOT provide religious instruction or counseling,
conduct any religious worship or services, or engage in any religious
proselytizing, or exert any religious influence in the provision of the services
in said program.
D. Where the services to be provided under said program are rendered
on property owned by the primarily religious entity CONTRACTOR, FEZ
funds may also be used for minor repairs to such property which are directly
related to the cost of rendering the services under said program, where the
cost constitutes in dollar terms only an incidental portion of the FEZ
expenditure for rendering the services under said program.
VI. PROHIBITION OF NEPOTISM
CONTRACTOR agrees not to hire or permit the hiring of any person to fill a position
funded through this Agreement if a member of that person's immediate family is
employed in an administrative capacity by CONTRACTOR. For the purposes of
this section, the term "immediate family" means spouse, child, mother, father,
brother, sister, brother-in-law, sister-in-law, father-in-law, mother-in-law, son-in-law,
daughter-in-law, aunt, uncle, niece, nephew, step-parent and stepchild. The term
"administrative capacity" means having selection, hiring, supervisor or management
responsibilities.
VII. NOTICES
Notices to the parties shall, unless otherwise requested in writing, be sent by U.S.
Mail, postage prepaid, and addressed as follows:.
TO CITY: Santa Ana WORK Center
WORK Center Director
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, California 92701
Telefacsimile (714) 565-2602
TO CLERK: Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 82702-1988
Telefacsimile (714) 647-6956
TO CONTRACTOR:
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VIII. ASSIGNABILITY
CONTRACTOR shall not assign nor transfer any interest in this Agreement,
whether by assignment or novation, without the prior written consent of CITY;
provided, however, that claims for money due or to become due CONTRACTOR
from CITY under this Agreement may be assigned to a bank, trust company or
other financial institution, or to a trustee in bankruptcy, without such approval.
Notice of any such assignment or transfer shall be promptly furnished to CITY.
IX. HOLD HARMLESS
CONTRACTOR shall indemnify and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all damages to or
for loss of use of property and for injuries to or death of any person or persons,
including property and employees or agents of CITY, and shall defend, indemnify
and save harmless CITY, its officers, employees, agents, representatives and
volunteers from and against any and all claims, demands, suits, actions or
proceedings of any kind or nature, including, but not by way of limitation, workers
compensation claims and including attorney fees and reasonable expenses for
litigation or settlement, resulting from or arising out of.the negligent or wrongful
acts, errors or omissions of CONTRACTOR, its officers, directors, employees,
agents, subcontractors and suppliers arising out of CONTRACTOR's performance
of this Agreement.
X. INSURANCE
CONTRACTOR shall obtain and maintain for the entire term of this Agreement
comprehensive general public liability insurance, in companies acceptable to the
City, authorized to issue such insurance in the State of California. Said
insurance shall consist of the following:
A. Commercial General Liability. CONTRACTOR agrees to obtain and keep
in force during the term of this Agreement a policy of comprehensive
commercial public liability insurance insuring the State of California, CITY,
and CONTRACTOR against any liability for accident, injury or death
arising out of or in consequence of this Agreement. Such insurance shall
be in an amount not less than One Million Dollars ($1,000,000.00) for any
injury to or death of any person or persons in any single accident or
occurrence. Said policy of comprehensive public liability insurance shall
be endorsed to provide to CITY and to the State of California, Employment
Development Department, at least thirty (30) days written notice prior to
cancellation; name CITY, its officers, agents, employees, and volunteers,
and the State of California, its officers, employees, and volunteers as
additional insureds; and state that such coverage is primary to any other
coverage or self-insurance of the State of California and CITY.
Governmental entities may substitute a certificate of self-insurance.
Page 9 of 14
B. Automobile Liability Coverage. CONTRACTOR shall also obtain and
maintain, during the effective period of this Agreement, broad form
automobile liability coverage with a $1,000,000 limit unless reduced by
CITY, which applies to both owned/leased and non-owned automobiles
used by CONTRACTOR employees or participants in performance of this
Agreement, or, in the event that CITY will not utilize such ownedlleased
automobiles but intends to require employees, participants or other agents
to utilize their own automobiles in'the performance of this Agreement,
CONTRACTOR shall secure and maintain on file from all such employees,
participants, or agents as self-certification of automobile insurance
coverage. Governmental entities may substitute a certificate of self-
insurance.
C. Workers' Compensation. If CONTRACTOR is an "employer", as set forth
in California Labor Code. Section 3300 et seq., or utilizes participants as
"employees," as set forth in Califomia Labor Code Section 3350 et seq.,
CONTRACTOR shall obtain and keep in force during the term of this
Agreement full Workers' Compensation insurance coverage for injuries
suffered by participants. Said insurance policy shall guarantee CITY at
least thirty (30) days written notice of cancellation or modification.
CONTRACTOR shall carry medical and accident insurance for those
participants not qualifying as "employees' for Worker's Compensation
Coverage, pursuant to California Labor Code Section 3350, et seq.
D. Equipment Coverage. CONTRACTOR shall purchase a policy or policies
of insurance covering loss or damage to any and all Equipment provided
to or purchased by CONTRACTOR in accordance with this Agreement.
Said insurance shall be in the amount of the full replacement value
thereof, providing protection against the classification of fire, extended
coverage, vandalism, malicious mischief, theft, and special extended
perils. Governmental entities may substitute a certificate of self-insurance.
E. Proof of Insurance. Certificates and endorsements (Exhibit H) must be
submitted and approved by CITY prior to any work under this Agreement.
CONTRACTOR understands that CITY will make no payments under this
Agreement until the required certificates and endorsements have been
approved by CITY.
XI. REVERSION OF ASSETS
A. Upon the expiration of this Agreement, CONTRACTOR shall transfer
to CITY any FEZ funds on hand at the time of the expiration of this
Agreement as well as any accounts receivable attributable to the use of FEZ
funds.
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B. Any real property under CONTRACTOR'S control that was acquired
or improved in whole or in part with FEZ funds in excess of $25,000.00 must
either be:
1. Used, where CITY has given written approval, to meet
one of the national objectives stated under federal law until five (5)
years after expiration of this Agreement, or for such longer period of
time as determined to be appropriate by CITY; or
2. If not used in accordance with subparagraph A above,
CONTRACTOR shall pay to CITY an amount equal to the current fair
market value of the property less any portion of the value attributable
to the expenditure of non-FEZ funds for acquisition of, or
improvement to, the property. Such payment is program income to
CITY.
C. Subject to the obligations set forth herein, title to equipment acquired
under the terms of this Agreement will vest upon acquisition in
CONTRACTOR. When said equipment which has been acquired in
accordance with this Agreement and all applicable regulations is no longer
needed for said program, disposition. of said equipment will be made as
follows:
1. Items of equipment with a current per unit fair market
value of less than $5,000.00 may be retained, sold or otherwise
disposed of with no further obligation to CITY.
2. Items of equipment with a current fair market per unit
value of $5,000.00 or more may be retained or sold and CITY shall
have the right to an amount calculated by multiplying the current
market value or proceeds from the sale by CITY's share of federal
funds used to acquire the equipment.
C. CONTRACTOR hereby agrees, upon the demand of CITY, to execute,
acknowledge and deliver, or cause any person or entity who may have any
claim to rights hereunder or under any document, instrument or agreement
executed in furtherance of the services and activities to be performed
hereunder, to execute, acknowledge and deliver, to CITY assignment(s),
quit claim deed(s) or such other and further instruments, documents and
agreements as may be necessary, in the sole and absolute discretion of
CITY, to vest in CITY all of CONTRACTOR'S right, title and interest (if any it
may have) in and to CITY, SAEC, FEZ or other federal, state andlor local
accounts or program funds or allocation of funds to which CITY is or may be
entitled, either for its own account or as fiduciary or trustee for others, which
were obtained for the purpose of the performance of this Agreement or any
previous agreements relating to the same subject matter or activities as this
Agreement, together with any instruments, loans, grants or advances by
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CONTRACTOR on behalf of CITY, in furtherance of the activities hereunder
or thereof.
CONTRACTOR's obligations and responsibilities set forth in this paragraph
"XI. REVERSION OF ASSETS," and in paragraphs "XII. TERMINATION"
and "III. PROGRAM INCOME" shall not be affected by the termination of this
Agreement and shall survive the date of termination of this Agreement for
such period of time as CITY and/or HUD deems necessary for the
responsibilities, duties and obligations to be performed and completed to the
satisfaction of CITY and HUD.
XII. TERMINATION
A. This Agreement may be terminated on thirty (30) days' written notice by
either party. In the event of such termination, CONTRACTOR shall only be
entitled to reimbursement for approved expenses incurred to the effective
date of termination.
B. This Agreement may be suspended or terminated by CITY upon five
(5) days' written notice for violation by CONTRACTOR of the terms and
conditions of the this agreement or applicable State or Federal
requirements. In the event of such suspension or termination,
CONTRACTOR shall only be entitled to reimbursement for approved
expenses incurred up to the effective date of suspension or termination.
C. In the event CONTRACTOR defaults by failing to fulfill all or any of its
obligations hereunder, CITY may declare a default and termination of this
Agreement by written notice to CONTRACTOR, which default and
termination shall be effective on a date stated in the notice which is to be not
less than ten (10) days after certified mailing or personal service of such
notice, unless such default is cured before the effective date of termination
stated in such notice. If terminated for cause, CITY shall be relieved of
further liability or responsibility under this Agreement, or as a result of the
termination thereof, including the payment of money, except for payment for
approved expenses incurred for services satisfactorily and timely performed
prior to the mailing or service of the notice of termination, and except far
reimbursement of (1)any payments made for services not subsequently
performed in a timely and satisfactory manner, and (2) costs incurred by
CITY in obtaining substitute performance.
D. The grant of funds by CITY to CONTRACTOR pursuant to this
Agreement may be terminated for convenience upon two weeks written
notice to CONTRACTOR.
E. In the event this Agreement is terminated as set forth in
subparagraphs XII.A. through XII.D., inclusive, CONTRACTOR agrees to
immediately return to CITY upon CITY's demand and prior to any
Page 12 of 14
adjudication of CONTRACTOR'S rights, any and all funds not used, and to
comply with paragraph "XI. REVERSION OF ASSETS" of this Agreement.
XIII. LIMITATION OF FUNDS
The United States of America, through HUD, may in the future place programmatic
or fiscal limitations on the use of FEZ funds which limitations are not presently
anticipated. Accordingly, CITY reserves the right to revise this Agreement in order
to take account of actions affecting HUD program funding. In the event of funding
reduction, CITY may, in its sole and absolute discretion, reduce the budget of this
Agreement as a whole or as to costs category, may limit the rate of
CONTRACTOR'S authority to commit and spend funds, or may restrict
CONTRACTOR's use of both its uncommitted and its unspent funds. Where HUD
has directed or requested CITY to implement a reduction in funding, in whole or as
to a cost category, with respect to funding for this Agreement, CITY'S Executive
Director or delegate is authorized to act for CITY in implementing and effecting
such a reduction and in revising, modifying, or amending the Agreement for such
purposes. Where CITY has reasonable grounds to question CONTRACTOR's
fiscal accountability, financial soundness, or compliance with this Agreement, CITY
may suspend the operation of this Agreement for up to sixty (60) days upon five (5)
days written notice to CONTRACTOR of its intention to so act, pending an audit or
other resolution of such questions. In no event, however, shall any revisions made
by CITY affect expenditures and legally binding commitments made by
CONTRACTOR before it received notice of such revision, provided that such
amounts have been committed in good faith and are otherwise allowable and that
such commitments are consistent with HUD cash withdrawal guidelines.
XIV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing,
between the parties hereto with respect to the use of CITY's FEZ funds by
CONTRACTOR and contains all the covenants and agreements between the
parties with respect to such employment in any manner whatsoever. Each party to
this Agreement acknowledges that no representations, inducements, promises or
agreements, orally or otherwise, have been made by any party, or anyone acting
on behalf of any party, which are not embodied herein, and that no other
agreement or amendment hereto shall be effective unless executed in writing and
signed by both CITY and CONTRACTOR.
XV. LAWS GOVERNING THIS AGREEMENT
This Agreement shall be governed by and construed in accordance with the laws of
the State of California, and all applicable federal laws and regulations.
XVI. VALIDITY
The invalidity in whole or in part of any provision of this Agreement shall not void or
affect the validity of any other provision of this Agreement.
Page 13 of 14
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date
and year written hereinabove.
ATTEST:
PATRICIA E. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
~~ ~
By: Lisa Storck
.Assistant City Attomey
RECOMMENDED FOR APPROVAL
,abStephen G. arding, Deputy City Manager for
Developmen Services
Community Development Agency
CITY OF SANTA ANA, a municipal
corporation of the State of California
~~~A,v~,.t~
DAVID N. REA
City Manager
Title: .~rvs3
Federal Tax
~?-Dbo(~$~i
Page 14 of 14
I~..o,Cpc
Templo Calvario CDC
FEZ Daisy W6ee1 Network 2008-2009
BUDGET
Beginning 7/1/2008
Job Dev. Program Total FEZ
Case M Director
Personnel
Salaries $ 20,160 $ 39,000 $ 59,160
Benefits $ 9,800
Total Personnel Salaries & Benefits $ 20,160 $ 48,800 $ 68,960
O erating Ex enses
Administration $ 1,000
Rent or user fee $ 5,400
Phones $ 840
E ui ment (Com & Periph) $ 601
Marketing $ 146
Office Supplies $ 718
Training and Materials $ 90
Insurance $ 360
Accounting $ 975
Auditing/Legal counsel $ 650
Travel & Milea e $ 60
Support Services $ 1,200
Operating Ex enses Sub Total $ 12,040
Grand Total
Total Personel & O erating Esp. $ 81,000
EXHIBIT A
Federal Empowerment Zone
Templo Calvario Community Development Corp.
BUDGET NARRATIVE
July 1, 2008 -June 30, 2009
Personnel
Project Director: 1.0 FTE $ 39,000
Director will be responsible for daily management
activities. This position will carry a small case load.
Job Developer & Case Mgr: 0.625 FTE $ 20,160
Job developer will be responsible for maintaining job
opportunities and working closely with case managers
to place participants. This position will provide meetings and
build partnerships with the business community.
Total Program Staff $69,160
Other Costs:
Benefits $ 9,800
Includes Payroll taxes, group insurance, Work Comp, FICA,
SDI, SUI.
Total Personnel, Administration and Benefits $68,960
Operating Ezpenses
Administration $ 1,000
Administration will ensure completion of project, reporting,
Oversight of employees and participants, maintain grant file,
equipment and meetings with project coordinator and staff.
Rent: $ 5,400
Rent for office space and work azeas.
EXHIBIT A
Phones: $ 840
Telephone and Internet service.
Office Expense/ Postage $ 718
General program supplies, paper, toner, ink, pens, etc.
Equipment
Computer, Peripherals, printer, repairs, etc: $ 601
Marketing/ Printing/ Advertising: $ 146
Brochures, Flyers, Business cards, mailers, etc.
Training and Materials $ 90
Materials for training and staff/client training seminars.
Insurance: $ 360
Allocation of Liability Insurance/Comprehensive Ins.
Accounting & Payroll Services: $ 975
Ledger and accounting entries, consultation with CPA
Day to day accounting tasks
Audit /Legal Services: $ 650
Legal consultation on matters concerning legalities.
Allocation of annual audit agency books including grant
Review,
Travel and mileage: $ 60
Mileage for program business, development, outreach, etc at
$0.45 per mile.
Supportive Services $ 1,200
Provision of Bus passes, food for work, work clothing,
Paper, pen, pencils, and whatever will assist clients to
Obtain and maintain work.
Total $ 12.040
Total Federal Empowerment Zone Budget $ 81,000
EXfiIBIT A
Templo Caivario, Community Development Corporation
FEZ Daisy Wheel Network Program
Scope of Work
July 1, 2008 - June 30, 2009
TERM
July 1, 2008 through June 30, 2009
[I. PURPOSE
The FEZ Daisy Wheel Network Program will provide vocationaUoccupational training, employment strategies,
education, and supportive services to individuals who reside in the Federal Empowerment Zone.
III. POPULATION TO BE SERVED
The population to be served aze Federal Empowerment Zone residents 16 years and older.
Eligibility will be determined by age, address, and by Right to Work documentation.
N. PROGRAM DESIGN, ELEMENTS, AND OUTCOMES FOR Templo Calvario, Community
Development Corporation
A. Program Design:
1. Provide an intake assessment (for screening) of each FEZ resident that includes a review of academic
and occupational skills levels as well as service needs;
2. Develop an Individual Service Plan including notifying achievement objectives.
B. Program Elements:
l . The following progam elements will be made available to eligible residents expected to enroll in the
FEZ Daisy Wheel Network Program for participation in activities aimed at providing a
comprehensive strategy that addresses employment and training needs:
i. vocationaUoccupational training,
ii. employment strategies,
iii. education, and
iv. supportive services
C. Performance Outcomes
.,. 90 FEZ residents will be served within 10 months.
:!. Of the 90 FEZ residents served, 45 (50%) will be provided additional services within 10 months.
3. Of the 90 FEZ residents served, 27 (30%) will be placed in unsubsidized employment within 10
months.
Cumulative Planned Enrollments: (90 total: 78 adults, 12 youth):
Jul - Se t. Oct -Dec. Jan. -March Aril
Adult Youth Adult Youth Adult Youth Adult Youth
31 5 16 2 23 4 8 1
Cumulative PLmned Additioaal Services - 50% (45 total: 39 adults, 6 youth):
Jul - Se t. Oct. -Dec. Jan. -March Aril
Adult Youth Adult Youth Adult Youth Adult Youth
16 2 8 1 12 2 3 1
EXHIBIT B
Cumulative Planned Placements - 30% (27 total: 23 adults, 4 youth):
Jul - Se t. Oct. -Dec. Jau. -March Aril
Adult Youth Adult Youth Adult Youth Adult Youth
5 1 9 2 7 1 2 0
V. SERVICES WILL BE PROVIDED AT:
Templo Calvario Community Development Corporation
2511 W 5th St
Santa Ana, CA 92703
Vl. WORK CENTER RESPONSIBILITIES
1. Develop contracts for partners.
2. Provide orientation and training on eligibility, referral process, assessment, MIS tracking system,
joint policies and procedures, fiscal billing, documentation, etc.
3. Develop joint forms such as application, screening/intake tool, ISP, referral form, MIS forms, etc.
~9. Perform Progam Monitoring
i. Perform Progam Reporting
~5. Provide partners with on-going technical assistance
1. Provide a quarterly FEZ newsletter
B. Facilitate monthly meetings
9. Provide job development /job placement enhancement services to partner agencies
10. Conduct a mid year progess review to access progammatic performance and fiscal accountability
VII. Templo Calvario Community Development Corporation RESPON5B31LITIES
1. Templo Calvario Community Development Corporation will provide eligible FEZ residents with
services designed to meet the FEZ Board requirements. A participant will be provided with one or
more of the following services to assist them in obtaining unsubsidi2ed employment and seif-
sufficiency:
• Case management
• Job readiness
• Job development & job placement
• Coordinate on-site recruitments
• Community forums on job related services
Z. Evaluate participants for eligibility and assign those eligible for program services.
.I. Report progress and job placements to WORK Center FEZ staff.
4. Incorporate all service navigator partners' information into each other's marketing materials.
`i. Attend monthly partner meetings.
C>. Provide WORK Center FEZ staffwith monthly and quarterly progess reports.
"T. Provide WORK Center FEZ staff with necessary information for conducting informal and formal
monitoring of progam progess.
Ft. Meet performance measures. All staff and agencies participating in this project will be held
accountable for achieving their agency FEZ performance measures.
9. Submit Monthly Statistics Report documentation to FEZ Liaison staff by the 5th of every month.
Report should include new enrollments and a continuous Activity Enrollment Form
10. Maintain a current and complete file (electronic as well as a hard copy) for each FEZ participant
eligibility documentation; registration form; enrollment form; assessment; Individual Service Plan
(ISP); EEO/Grievance; case notes; supportive services documentation; attendance records; training
documentation; etc.
11. Comply with allowable expenses. To be allowable, costs must: aJ be reasonable for the performance
of the program; b) conform to any limitations or exclusions set forth in the progam as to types or
amount of cost items; c.) be consistent with policies and procedures that apply uniformly to both
EXHIBIT B
federally-fmanced and other activities of the organization; d.) be determined in accordance with
generally accepted accounting principles (GAAP); e J not be included as a cost or used to meet cost
sharing or matching requirements of any other federally-financed program in either the current or a
prior period; and, f.) be adequately documented.
12. Submit in triplicate, a monthly Invoice on City of Santa Ana, Federal Empowerment Zone Program
Subrecipient Request for Reimbursement, showing in detail the amount of money already expended.
Accounting records must be supported by source documentation such as cancelled checks, paid bills,
payrolls, and attendance records. Submit the above stated documents to Bea Gonzalez by the tenth
(10`") day of the month following the month in which services are performed.
EXHIBIT B
SUBREC]PIENT warrants the following
l . SUBRECIPIENT will comply with Public Law 88-352, title VI of the Civil Rights Act of
1964 (42 U.S.C. §2000 ET SEQ.) and implementing regulations in 24 CFR Part I.
2. No person in the United States shall op the ground of race, color, religion, national origin, or sex,
be excluded from participation in, or be denied the benefits of, or be subjected to discrimination under,
any program or activity funded in whole or in part with community development funds made available
pursuant to the ACT.
3. All laborers and mechanics employed by contractors or subcontractors in the performance of
construction work fnumced in whole or in part with community development funds shall be paid wages
at rates not less than those prevailing on similar construction on the locality as determined in accordance
with the Davis-Bacon Act, as amended, 40 U.S.C. § §276a-276a-5, except for individuals who perform
services for which they volunteered; do not receive compensation for such services; or are paid expenses,
reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time in
construction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded with community
development funds, except that (a) SUBRECIPIENT does not assume CITY's environmental responsibilities
described at 24 CFR 570.604; and (b) SUBRECIPIENT does pot assume CiTY's responsibility for initiating
the review process under Executive Order 12372.
EXHIBIT C
Certification Regarding Lobbying
Certification for Contracts, Grants. Loans. and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congess in connection with the awarding of any Federal contract, the making of any Federal
grant, the malting of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any Federal contact, grant, loan,
or cooperaive agreemem.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification be included in the awazd
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, tide 31, U.S. Code. My person who
fails to file the requved certification shall be subject to a civil penalty of not less than $10,000 and
not more than $100,000 for each such failure.
~~~ o l.A ~~4 V'; o C~ ~~Z -~ a ~.U~.u
GranteelCon r Organization Pro Title
~'
~~z~~r ~e e~~ ~ ~-2-~3
Name of Certifying Officer Si Date
EXHIBIT D
Part I
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTMTIES
This disclosure form still be completed by the reporting entity, whether subawardee or prime Federal recipient, at the Initiation or receipt of a covered
Federal action, or a material change to a previous filling, pursuam m title 31 U.S.C. section 1352. The filling of a form be required for each payment or
agreement m make payment for any lobbying entity for influrncing or attempting m influrnce rn officer or employee of airy agency, a member of
Congress an officer or empbyee of Congress, or en employee of a Member of Congress in connection wiOr a Federal Action. Used the SF-LIY-A
ContlnuaOon Sheet for addhional information if the space on the form is irmdequate. Complete all itans tltm appy for both the initial filling and material
change report. Refer m the Implememing guidance published by the ()<t'ice of Management and Budget for additional information.
1. Identify the type of covered Federal Action for which lobbying activity is and/or has been secured m influence the outcome of a covered Federal
action.
2. Identify the crams of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change [o the information previously reported,
enter the year and quarter m which the change occurred. Enter the dme of the last previously submitted report by this reporting entity fbr this
covered Federal action.
4. Enter the fu0 name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate
classification of the reporting amity [hat designates if it is, or expects m be, a prime or subaward recipient. Identify the tier of the subawardee, e.g,
the first subawardee of the prime is the 1° tier. Seaboard include but are not limited to subwntrects, subcontracts, subgraMS and corrtract awards
under grants.
5. If the organization filling the report in item 4 checks "subwardee" then enter the full name, address, city, state and zip code of [he prime Federal
recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan wmmitment. Include ai least one organva[ienal level below agency name, if
known. For example, Department of Transportation, United States Coast Gourd.
7. Enter the Federal progrwn name or description for the covered Federal action (iteml). If known, enter the full Camlog of Federal Domestic
Assismnce (CFDA) number for gmmts, cmoperaOve agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.) Request for Proposal (RFP)
number; invimtion for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the applicationlproposal control
number assigned by the Federal agency). Include prefixes, e.g. "RFP-DE-90-001"
9 For a covered Federal action where these has bcen an award or loan commitment by Ote Federal agency, enter the Federal amount of Ute award/loan
commitment for the prime amity idrntified in rtem 4 or 5.
10. (a) Enter the full name, address, city, stace and zip code of the lobbying entity engaged by the reporting entity identified in item 4 m influence the
covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if diBerem from 10 (a). Enter Last Name, First Name, and
Middle initial (Mf).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate
whether the payment has been made (actual) m will be made (planned). Check all boxes that apply, if this is a material change report, enter [he
cumulative amount of payment made m planned m be made.
L2. Check the appropriate box(es). Check all boxes that apply, if payment is made through an in-kind contribution, specify the nature and value of the
in-kind payment.
13. Check the appropriate box(es). Check all boxes Otat appy. If other, specify nature.
14. Provide a specific and derailed description of the services that Me lobbyist has performed, or will be expected to perform, and the date(s) for any
services rendered. Include all preparatory and related activity, not just time spent m acntal contact with Federal officials. Identify the Federal
officislfs) or employee(s) wmacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.
I5. Check whether ornot a SF-LLL-A ConOnuation Sheet(s) is attached.
16. lire certifying official shall sign and date the form, print his/her name, title, and telephone number.
Public reporting 6urdeo for this collectoa of information is estimated to average 30 minutes per response, including time for reviewing insrruaions
searching existing dam sources, gathering and maintaining the data needed, and completing amd reviewing the collection of information. Send comments
regrading Ore burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, m the Office of
Managemem and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C.20503.
EXHIBIT D
Part R
ACKNOWLEDGEMENT OF
SLTBRECIPIENT AGREEMENT
'I'o: Stephen G. Hazding
Executive Director
Santa Ana Empowerment Corporation
From: Subcontractor/Assignee
Subcontractor/Assignee hereby stipulates that it has been provided with a copy, has read,
and is familiar with all of the terms of SUBRECIPIENT's Agreement with the Santa Ana
Empowerment Corporation.
Subcontractor/Assignee further agrees to be bound to all of the teens and provisions of
SUBRECIPIENT's Agreement with the Santa Ana Empowerment Corporation.
Executed this -1~ day o~ ~ wVl2 , 2 0 ~ .
BY:
N~re~ ~ ~.e. ~p~n
Title: ,py~ /CE D
EXHIBIT E
Certification Reaardina Drua-Free Workaiace Requirements
The cert~cation set out below is a material representation upon which reliance is placed
by the U.S. Department of Housing and Urban Development in awarding the grant. If it
is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug-Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug-Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide adrug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing adrug-free awareness program to inform employees about-
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining adrug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph -(a) that,
as a condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after
such conviction.
EXHIBIT F
Pg. 2
(e) Notifying the U.S. Department of Housing and Urban Development within
ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
(f) Taking one of the following actions, within 30 days of receiving notice
under subparagraph (d)(2), with respect to any employee who is so
convicted -
( 1) Taking appropriate personnel action against such an employee, up
to and including termination; or
(2) Requiring such employee to participate satisfactorily in a drug
abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain adrug-free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, if it is subsequently determined that additional
sites wil- be used #or the performance of work under the contract, it shall notify
the U.S. Department of Housing and Urban Development immediately upon the
decision to use such additional sites by submitting a revised "Place of
Performance"form.
Dated: ~D ~2 ~~~
EXHIBIT F
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE
WORKPLACE REQUIREMENTS
Name: ~l'P-4 71~~( G~ 2- ~~ vt
Name of Contractor: ~n I D ~~ ~ t1CLr ~ o C ~-'
Contractor Number:
Date: ~ ^Z-~
The Contractor shall insert in the space provided below the site(s) expected to be used
for the performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):
EXHIBIT F
g2~o3
Subcontractor agrees that in addition to those agreements and obligations
specified in the contract boiler plate and scope of work, it will also adhere to and
obey the following provisions, assurances, and certifications.
ARTICLES
1) Subcontractor assures and certifies that it will not use any funds
appropriated under this agreement for religious activity or anti-religious
activity, or to promote or oppose any political candidate, parties, andlor
beliefs.
2) Contractor assures and certifies that where applicable, classroom training
instructors are properly credentialed, and training curriculums comply with
State Education Codes.
3) Subcontractor assures and certifies that any requested mod cation to this
agreement must be submitted in writing, explaining requested changes
and rationale. Subcontractor further assures that no modification will be
implemented without prior written approval from the Santa Ana WORK
Center.
4) Contractor assures and cert~es that they are in good standing with the
California Secretary of State Franchise Tax Board and Internal Revenue
Service.
5) Subcontractor agrees to cooperate with any monitoring, inspection, audit,
or investigations of activities related to this agreement as may be
scheduled and conducted by the Santa Ana WORK Center or the Santa
Ana Empowerment Corporation.
6) Subcontractor agrees to acknowledge (give credit) the Santa Ana WORK
Center and the Santa Ana Empowerment Corporation as the source of
funds in all oral presentations, written document, publicity, and
advertisements regarding any activities that ensue from this agreement.
EXHIBIT G
CERTIFICATE OF LIABILITY INSURANCE °$M°L°1 V~~oS~os~ae
MATION
ACORO. FICATE IS ISSUED AS A MATTER OF INFOR
THIS CERTI
CONFERS NO RIGHTS UPON THE CERTIFICATE
PRDDXLEP
iates ONLY AND
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
HOLDER
Chapman a Assoc .
COVERAGE AFFORDED BY THE POLICIES BELOW.
License #0522024 ALTER THE
P. O. eox 5455
NAIC #
Pasadena CA 91117-0455 INSURERS AFFORDING COVERAGE
Phone: 626-405-8031 Fax: 626-405-0585 j
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Templo Calvaiio Community Deve !FSLPERn
2617 West 5th St
Santa Ana CA 92703 PEPE
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ce of cancellation for non-payment of
CERTIFICATE
City of Santa Ana
1000 E. Santa Ana Hlvd., #200
Santa Ana, CA 92701
CTYSAN9 SMDVID AXY OF THE A60VE DEELRIBED FOUCIES RE CPNCELIFV PEFOPE TIE EIDINPiION YS wRIirEX
OAR HEREOF, LME REUINOIXFVRER WILLWXR.MYI MAIL 30
MOLICE r0 T1E CERTIFICATE XOLVER NP.MEO TI LXE LER. WTFwMVRIFwwwwN'wOwE
IMPORTANT
If the cerliflcate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certifcate does not confer rights to [he certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the cerliftcate holder, nor does it
affvmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ADDITIONAL INSURED AGREEMENT
FOR CONIIvtERCIAL GENERAL LIABII,ITY POLICY
Insurance Company No_ nnr~fita InciirancP Alliance
This agreement modifies such insurance as is afforded by the provisions of Policy #
2D0817088NP0 relating to the following'.
1 The Santa Ana Empowerment Corporation and the City of Santa Ana, 20 Civic
Center Plaza, P.O. Box 1988, Santa Ana California 92702; and their respective
officers, employees, agents, volunteers and representatives are named as
additional insureds ("additional insureds") with regard to liability and defense of
suits arising from the operations and uses performed by or on behalf of the named
insured.
2. With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is
primary and is not additional to or contributing with any other insurance carried
by or for the benefit of the additional insureds.
,, This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability The
inclusion of any person or organization as an insured shall not affect any right
which such person or organization would have as a claimant if not so included.
4 With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after ten (10) days written
notice has been given to the Santa Ana Empowerment Corporation, Inc. 20 Civic
Center Plaza (M-21), P.O. Box 1988, Santa Ana, California 92702.
(Completion of the following, including countersignature is required to make this
agreement effective.)
Effective 6-4-08 ,this agreement form as a part of
Policy # 200817088NPO
Issued to Templo Calvario Community Development
Name Insured
Countersigned b
Authorize entative
EXHIBIT H
CERTIFICATE OF LIABILITY INSURANCE OTEMPL CI OS/OS/OB
OF INFORMATION
~
acoRD THIS CERTIFICATE IS ISSUED AS A MATTER TE
CONFERS NO RIGHTS UPON THE C ERTIFICA
PRODUCER ONLY AND
ERTIFICATE DOES NOT AMEN D, EXTEND OR
Chapman & Associates HOLDER. THIS C
RAGE AFFORDED BY THE POLICIES BELOW.
22024 ALTER THE COVE
License #05
p. o. Box 5455 NAIC #
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Pasadena CA 91117-04 5 5 INSURERS AFFORDING COVERAGE _ __ -
626-405-8031 Fax: 626-405-0585
Phone: -
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Templc Calvar io CoEmnuni ty Deve NsePERD -- -'- ~
2617 West 5th St
Santa Ana CA 92703 suRERE
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GEECRIPPOX Of OPERPTON51 LOCALIONS I VEXICLE51 EFL W SANS AOOEO RY EHOOREEMEMi I EPECIPL PROVISIONS
Evidence of coverage. 10 days notice of cancellation for non-payment of
premium. ~ ~ /
- /l-i'-'C~~-C~ //~
CERTIFICATE
City of Santa Ana
1000 E. Santa Ana Slvd., #200
Santa Ana, CA 92701
CANCELLATION
CTYSAN9 EMOVLY AMY OF iXE ABOVE GESCRIBEO POYGES RE CANCELLED RE50RE tNE ERPtlLAiIOM yS WRIriEM
OPiE FMEREO S.iME I34YINOIXSUREP WILL EYYEAIR"YO NAR 30
OFICE i0 ME CERFIEICAiE MOLDER NAMED iO iXE 1EEt.5W'WMMRCMlOSWTN'R
1988
IMPORTANT
If the certlfcate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certifcate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The certifcate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affrmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ADDITIONAL INSURED AGREEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company ionnrnfit Inc iranr•P Allianre
This agreement modifies such insurance as is afforded by the provisions of Policy #
200817088NP0 relating to the following:
1 The Santa Ana Empowerment Corporation and the City of Santa Ana, 20 Civic
Center Plaza, P.O. Box 1988, Santa Ana California 92702; and their respective
officers, employees, agents, volunteers and representatives are named as
additional insureds ("additional insureds") with regard to liability and defense of
suits arising from the operations and uses performed by or on behalf of the named
insured.
2, With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is
primary and is not additional to or contributing with any other insurance carried
by or for the benefit of the additional insureds.
,. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability The
inclusion of any person or organization as an insured shall not affect any right
which such person or organization would have as a claimant if not so included.
4 With respect to the additional insureds, this insurance shall notl0e da sel~ed~ten
materially reduced in coverage or limits except after ten ( ) Y
notice has been given to the Santa Ana Empowerment Corporation, Inc. 20 Civic
Center Plaza (M-21), P.O. Box 1988, Santa Ana, California 92702.
(Completion. of the following, including countersignature is required to make this
agreement effective.)
Effective 6-4-08 _, this agreement form as a part of
Policy # 200817088NPO
Issued to Templo Calvario Community Development
Name Insured
Countersigned b
Authorize entative
EXHIBIT H
RD CERTIFICATE OF LIABILITY INSURANCE
DA
E
C
Y
)
l
02 19
T
MPL
09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Box 5455
O
P
.
.
Pasadena CA 91117-0455
Phone: 626-405-8031 Fax:626-405-0585 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Nonprofits' Insurance Alliance
INSURER B: Everest National
Deve
lo Calvario Communit
T INSURER C:
y
emp
2617 West 5th St INSURER D:
Santa Ana CA 92703
INSURER E:
rnvFRnc;FS
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH RESPECT TO W RICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE M~DDm PDATE MMPDOIW N UMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1, O O O, O O O
A
X
X
COMMERCIAL GENERAL LIABILITY
2 U 0 917 0 8 8NP0
0 2~ U 8~ 0 9
0 2~ 0 8~ 10 E~xENT>:>T
PREMISES (Ea occurence) $ 10 0 , 0 0 0
CLAIMS MADE a OCCUR MED EXP (Any one person) $ 10 , 0 0 0
PERSONAL 8 ADV INJURY $ 1, O O O, O O O
GENERAL AGGREGATE $ 2, 0 0 0, O O O
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGG $ 1, O O O , O O O
X POLICY PRO LOC
JECT
AUT OMOBILE LIABILITY COMBINED SINGLE LIMB
$ 10 0 0 0 0 0
A ANY AUTO 200917088NP0 02/08/09 02/08/10
(Ea accident)
ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
~[ HIRED AUTOS BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
~~
1 ~
~ PROPERTY DAMAGE $
1 (Per accident)
GARAGE LIABIUTr Rp AUTO ONLY - F1+ACCIDENT $
ANY AUTO Y
~~ ^ ~ ~ OTHER THAN EA ACC $
~
~/~ •, ~
' t AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY ~ 3
i'~V« ~ FACH OCCURRENCE $
C
~1 y
OCCUR ~ CLAIMS MADE 51St
n~
AGGREGATE
$
AS
$
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X TORY LIMITS ER
B EMPLOYERS'LIABILITY 6600001002091 01/01/09 Ol/O1/10 E.L. EACH ACCIDENT $ 1000000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DI$~1CSE • EA EMPLOYE
$ l O O O O O O
If yes, describe under
SPECIAL PROVISIONS below ~,-'.
E.L. DISE~ LICY
$ 10 0 0 0 0 0
OTHER ~ ~ "
"~ ---.~~
DESCRIPTION OF OPERATIONS !LOCATIONS / VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS ~ -'
W
The Santa Ana Empowerment Corporation and the City of Santa Ana, and their',
respective officers, employees, agents, volunteers and representatives are-.;
named additional insured with respect to the operations of the named insu~~e3•=`
.~
per the attached CG 2026 endorsement. Such insurance is primary and ~•j~-^
non-contributory. Workers Compensation coverage excluded, evidence (Contdf=: ap
CERTIFICATE HOLDER CANCELLATION
Santa Ana Empowerment
Corporation, Inc.
20 Civic Center Plaza (M-21)
P.O. Box 1988
Santa Ana, CA 92702
SANTAAE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
25 (2001108) ~ t
,Jx:~r-',~ cyfi -,~ - ~~ -1 S~
ORA
N®TE
only. 10
days notice of cancellation for non-payment of premium.
TEMPI-1 PAGE 3
.x::OP lD ?,PC ;~ DATE 02/19/09
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
POLICY NUMBER:20091708$NPO
COMMERCIAL GENERAL LIABILCC1f
CG 20 26 0? 04
THIS ENDORSEMENT CHANGES THE P+ULICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -DESIGNATED
PERSON OR ORGANISATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
~ Name Of Additional Insured Personts) Or Oraaniiation(s) ~
Any person or organization that you are required to add as an additional insured on this policy, under
a written contract or agreement currently in effect, or becoming effective during the term of this policy,
and for which a certificate of insurance naming such person or organization as additional insured has
been issued, but only with respect to their liability arising out of their requirements for certain perform-
, ante placed upon you, as a nonprofit organization, rn consideration for funding or financial contnbu-
tionsyou receive from them. The additional insured status will not be afforded w~h respect to liability
arising out of or related to your activities as a real estate manager for that person or organization.
IThe Santa Ana Empowerment Corporation and the Cfty of Santa Ana, and their respective officers,
employees, agents, volunteers and representatives
Information required to complete this Schedule if not shown above, will be shown in the Declarations. I
Section II -Who is An Insured is amended to in-
clude as an additional insured the perscn(s) or or-
garnzation(s} shown in the Schedule, but only with
respect to liability for '"bodily injury", "property dam-
age" or "personal and advertising injury" caused, in
whole or in part, by your acts or omissions or the acts
or omissions of those acting on your behalf:
A. In the performance of your ongoing operations; or
B. in connection with your premises owned by or
rented to you.
GG 20 2fi 47 04 ®ISO Properties, Inc., 2004 Page 1 of 1 ^